RECESSION: GINGIVAL RECESSION

In July, 2013, the AAP Glossary Workgroup added the term “periodontal recession” to the Glossary and cross referenced with the term “gingival recession”.

I suggest the diagnostic term "gingival recession" be replaced or supplemented with the term "periodontal recession".
The nature of recession encompasses more than just the gingiva. Exposure of the tooth root through apical movement of the gingival margin reflects loss of the entire periodontal complex that should cover the root in the normal anatomic context. Rather than being a loss of gingiva as suggested by the current diagnostic term "gingival recession", the more accurate diagnosis of "periodontal recession" describes the loss of of gingiva plus the other components of the periodontium that results in the exposure of the tooth root.
The suggested correction/amendment of this diagnostic term also improves the consistency of periodontal diagnostic terms as it follows the precedent established by the difference in the terms "gingivitis" and "periodontitis". As such, "gingivitis" describes inflammation affecting only gingiva and "periodontitis" describes inflammation affecting all periodontal tissues.
On a subjective note, the term "periodontal" clarifies the deeper effects of such loss of support around the tooth, giving the concept of recession the appropriate "gravitas" that should accompany the loss of bone and other supporting tissues. Too often, "gingival recession" is addressed solely as an esthetic issue without regard for its implication in future dental health including increased risk for root caries, future bone loss/recession, plaque control problems, etc. This will also better communicate to third parties the true impact of "periodontal recession", and clarifies the justification for allowing benefits and reimbursement to practitioners for correction of these defects.
To fully sanction "periodontal recession" as a diagnostic term, it must be adopted by the World Health Organization in its International Classification of Diseases (ICD). The current version is the ICD-10 which lists terms "recession" and "gingival recession" only. If "periodontal recession" is adopted into the AAP Glossary, I would also recommend the Academy make the application to the WHO to include the new term in ICD-10 and future editions so periodontists can gain the maximum benefit of this adjustment to periodontal nomenclature.
Respectfully submitted,
James A. Simonds, D.M.D.
Santa Rosa, CA